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To introduce and evaluate a new, open-source algorithm to detect chest compression periods automatically by the rhythmic, high amplitude signals from an accelerometer, without processing single chest compression events, and to consecutively calculate the chest compression fraction (CCF).A consecutive sample of defibrillator records from the German Resuscitation Registry was obtained and manually annotated in consensus as ground truth. Chest compression periods were determined by different automatic approaches, including the new algorithm. The diagnostic performance of these approaches was assessed. Further, using the different approaches in conjunction with different granularities of manual annotation, several CCF versions were calculated and compared by intraclass correlation coefficient (ICC).131 defibrillator recordings with a total duration of 5755 minutes were analysed. The new algorithm had a sensitivity of 99.39 (95% CI 99.38, 99.41)% and specificity of 99.17 (95% CI 99.15; 99.18)% to detect chest compressions at any given timepoint. The ICC compared to ground truth was 0.998 for the new algorithm and 0.999 for manual annotation, while the ICC of the proposed algorithm compared to the proprietary software was 0.978. The time required for manual annotation to calculate CCF was reduced by 70.48 (22.55, [94.35, 14.45])%.The proposed algorithm reliably detects chest compressions in defibrillator recordings. It can markedly reduce the workload for manual annotation, which may facilitate uniform reporting of measured quality of cardiopulmonary resuscitation. The algorithm is made freely available and may be used in big data analysis and machine learning approaches.

Background Immune dysregulation and inflammation in patients with SARS-CoV-2 is associated with a poor clinical outcome. We investigated the value of the inflammatory markers tryptophan and kynurenine in predicting the survival outcome of patients with SARS-CoV-2. Methods The study included 252 inpatients with a SARS-CoV-2 infection hospitalized between August 2020 and April 2021. Two groups were generated based on disease survival (survival group: n = 199; deceased group: n = 53). Plasma concentrations of tryptophan, kynurenine and interleukin-6 (IL-6) were measured on admission. In a subset of patients (n = 105; 81 survivors and 24 deceased) concentrations of tryptophan and kynurenine were checked 7 days after admission. The kynurenine/tryptophan ratio (TRP/KYN ratio) was calculated. Results On admission, the deceased group showed significantly higher concentrations of kynurenine and a significantly higher KYN/TRP ratio compared to the survival group (p-values

Made available in DSpace on 2022-05-01T09:30:31Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 The construction of four large reservoirs for hydroelectric power generation in the main channel of the Paraná River and many others in the tributaries has eliminated important wetlands, except over an area of ∼2000 km2 between the reservoirs of the UHE Engenheiro Sérgio Motta (Porto Primavera) and the Itaipu. The up-river reservoirs created large changes in the river's hydrology and in its loads of suspended, bed and dissolved material. A detailed assessment of the impact of these changes requires a description and classification of the floodplain's different subunits, called macrohabitats, according to hydrological, hydromorphological, and vegetational parameters. The classification system presented herein is hierarchical and is embedded in the classifications of Brazilian wetlands. The system differentiates the Paraná River floodplain into 6 functional units, 13 subclasses, and 23 macrohabitats, which are presented in this paper. Changes in hydrology have reduced the flood amplitude, frequency and permanence, and thus confined the macrohabitats to an area currently subjected to a regular flood pulse of ∼3 m rather than the previous ∼6 m. The gradual terrestrialization of macrohabitats at the upper end of the flood gradient is expected, accompanied by a loss of macrohabitats at its lower end because of long-term flooding. The retention of sediments and dissolved nutrients in the reservoirs will lead to the oligotrophication of aquatic macrohabitats, the degradation of near-channel hydromorphic structures and their vegetation, and a general reduction of overall primary production in the floodplain, which may extend also to higher trophic levels. National Institute for Science and Development in Wetlands (INCT-INAU) Federal University of Mato Grosso (UFMT) Universidade Estadual de Maringá (UEM) Instituto SENAI de Inovação Biomassa BioLogic Consultoria Ambiental Universidade Estadual Paulista (Unesp) Universidade Estadual Paulista (Unesp)

PURPOSE The study was performed to evaluate the refractive and visual outcome of patients with misaligned toric intraocular lenses (IOLs) after operative realignment, with and without back-calculation of the toric axis after implantation of the IOL. DESIGN Institutional, retrospective case-control study. METHODS This is a retrospective case series of 39 patients who underwent a second operation to realign a misaligned toric IOL from August 2013 to December 2019 at the Department of Ophthalmology, Goethe University, Frankfurt, Germany. Ideal toric axis was calculated using the back-calculator astigmatismfix.com. RESULTS The study consists of 39 treated eyes (20 [51%] right eyes). The toric IOLs showed a postoperative misalignment of 25.69 ± 26.06°. Postrotational, uncorrected distance visual acuity (UDVA) improved from 0.39 ± 0.29 logMAR to 0.27 ± 0.18 logMAR. Refractive outcome showed a reduction of residual sphere and cylinder. The postoperative UDVA when performing alignment to the preoperative calculated axis (51%) was 0.24 ± 0.16 logMAR with a cylinder of 0.90 ± 0.90 diopter (D). In the group with alignment to a back-calculated axis (49%), the UDVA was 0.32 ± 0.20 logMAR with a cylinder of 0.76 ± 0.72 D. High cylinder power IOLs (≥2 D) showed a higher decrease in residual cylinder when back-calculation was performed than low cylinder power IOLs (

WE sought to evaluate differences in effective lens position (ELP) based on the lens design. Intraocular lenses (IOLs) with plate-haptic, c-loop haptic, and a rhexis-fixated lens were compared.Retrospective, multicenter, comparative case series.The study included patients having age-related cataract surgery with implantation of either a plate-haptic, c-loop haptic, or a novel rhexis-fixated IOL. Biometry and refraction measurements were conducted preoperatively and 3 months postoperatively. Lens constant optimization was performed.Seventy eyes of 56 subjects were included. ELP for rhexis-fixated IOL was shortest (4.29 ± 0.24 mm), followed by c-loop haptic (4.41 ± 0.42 mm) and plate-haptic (4.51 ± 0.26 mm) IOL. Difference in ELP was significant between rhexis-fixated IOL and both plate-haptic (P = .001) and c-loop haptic IOL (P = .000). Anterior chamber depth adjustment based on lens design showed a significant effect on refraction and IOL power predictions for all formulas and lenses (P.05). For the rhexis-fixated IOL the differences in refraction ranged from -0.039 diopters (D) for the Hill-Radial Basis Function to -0.096 D for Haigis. The other 2 lenses showed mean differences in refraction between +0.046 D for Hill-Radial Basis Function and +0.097 D for Haigis.The difference in IOL fixation and its resulting position in the capsular bag have a significant effect on the effective lens position and consequently a significant effect on the prediction of postoperative refraction.

A 29-year-old woman with a primary rib osteosarcoma declined treatment and was readmitted 20 months later in life-threatening condition caused by major local tumor progression with severe mediastinal shifting, and without distant metastases. She underwent extended tumor resection with palliative intent and recovered well after a prolonged course with post-pneumonectomy empyema. Further treatment was declined, and she presented again 4.5 years later with local chest wall recurrence that was completely resected. Currently, 7 years after diagnosis, the patient is free from disease. In this rare case, salvage surgery was associated with an unexpected favorable long-term outcome.

Background Pre-eclampsia is a pregnancy-specific disease characterized by onset of hypertension and proteinuria, sometimes progressing into damaging other organs. Here, we investigated the pathological significance of the soluble fragment of LR11 (sLR11), a cell differentiation regulator, in comparison to circulating IL-6 and TNF-α, in pre-eclampsia. Methods The study was conducted in a cross-sectional research design with fourteen pre-eclampsia patients and fifty healthy pregnant subjects. Pre-eclampsia was defined as hypertensive disorders in pregnancy at over 20 weeks of gestation with proteinuria. Results Plasma levels of sLR11 as well as IL-6 in pre-eclampsia were increased compared with those in the healthy pregnant subjects at the first, the second, and the third trimester. Receiver operating characteristic analysis for the detection of pre-eclampsia among third-trimester subjects showed that the areas under the curves of sLR11 and IL-6 were equivalent. sLR11 and IL-6 correlated positively with TNF-α in healthy pregnant subjects. In the pre-eclampsia patients, there was neither a correlation between sLR11 and IL-6 nor between sLR11 and TNF-α. Conclusions sLR11 increases during pregnancy, with levels further exaggerated in pre-eclampsia, and may be related to the pathology of pre-eclampsia.

Nanoparticle (NP)-based cell imaging offers good potential for future diagnosis tools in medicine. Gold and iron oxide NPs can be used as contrast agents for imaging by computed tomography (CT) and magnetic resonance imaging (MRI), respectively. Thus, also cells which have been labeled with these NPs may be tracked. This may be important for in vivo tracking of administered or transplanted cells. In this work, we optimized the conditions to label stem cells and macrophages with a library of gold and iron oxide NPs of different sizes (5–100 nm core diameter) and shapes. We investigated the amount of NPs which can be delivered to different cells, as well as their related toxic effects, in relation to the physicochemical properties of the NPs. Our study revealed that in general, when cells are exposed to NPs at similar elemental concentration (e.g., Au or Fe), bigger NPs lead to higher internalized elemental amounts as compared to exposure with smaller sized NPs. While the exposure concentrations are limited concerning the onset of toxicity, bigger NPs lead to better labeling than small NPs, resulting in improved contrast for imaging with enhanced biocompatibility.

Microglia, the brain’s resident immune cells, exhibit constitutive expression of the ionized calcium binding adaptor molecule 1 (IBA1), a cytoplasmic protein with actin and calcium-binding functions involved in membrane ruffling. Microglia are long-lived cells that exhibit a senescent morphology (dystrophy) with aging, which may be indicative of cell dysfunction. It has been reported that dystrophy of IBA1-positive microglia is exacerbated in obese humans. Our own preliminary studies of microglia in the medial temporal lobe of obese subjects have revealed another microglial abnormality, which is the loss of IBA1 immunoreactivity that can create large areas in the brain seemingly devoid of all microglial cells. Here, we systematically compared microglial appearance in human hippocampi derived from obese individuals compared to controls (nobese = 33, nnon-obese = 30). In both groups, we found areas that were negative for IBA1, but contained P2YR12 and glutathione-peroxidase 1 (GPX)-positive microglia. The number and extent of IBA1-negative regions was increased in obese cases. Since some cases of non-obese individuals also exhibited loss of IBA-1 immunoreactivity, we searched for possible confounders and found that hepatic dysfunction strongly impacts the distribution of microglial cells: By computational analysis of scanned IBA1-stained sections, we detected increased Mean Empty Space distances (p = 0.016) and IBA1-negative areas (p = 0.090) which were independent from the cause of liver dysfunction, but also from aging. Thus, we report on a novel type of microglia pathological change, i.e. localized loss of IBA1 that is linked, at least in part, to obesity and hepatic dysfunction.

Background The levels of plasma sLR11, released from intimal SMCs, are positively associated with intima-media thickness (IMT) in asymptomatic subjects. We have evaluated the yet unknown pathological significance of sLR11 for plaque conditions in patients with carotid artery stenosis. Methods The presence of LR11 in carotid plaques was investigated using autopsy specimens. A clinical ultrasonography study for elucidating relationships between sLR11 and plaque condition was performed in 46 patients. Results Immunohistochemistry showed high levels of LR11 in SMCs within thickened intima and at the media-intima border of atherosclerotic carotid plaques. The levels of sLR11 in patients were clearly elevated compared to healthy controls. Univariate analysis of sLR11 revealed significant positive correlation with plaque score and a tendency to correlate with the stenotic fraction. Univariate and multiple regression analyses of plaque scores showed that sLR11, maximum IMT, and HDL-cholesterol independently determined plaque score. Finally, univariate analysis of initial sLR11 levels for changes in imaging markers after one-year follow-up showed that initial sLR11 levels significantly correlated with stenotic fraction progression. Conclusions The levels of sLR11, abundantly expressed in carotid atherosclerotic plaques, are highly associated with increased plaque score. sLR11 levels may be predictive of plaque conditions in patients with advanced carotid atherosclerosis.

Lipoprotein(a) [Lp(a)] is an apolipoprotein B (apoB)-containing plasma lipoprotein similar in structure to low-density lipoprotein (LDL). Lp(a) is more complex than LDL due to the presence of apolipoprotein(a) [apo(a)], a large glycoprotein sharing extensive homology with plasminogen, which confers some unique properties onto Lp(a) particles. ApoB and apo(a) are essential for the assembly and catabolism of Lp(a); however, other proteins associated with the particle may modify its metabolism. Lp(a) specifically carries a cargo of oxidised phospholipids (OxPL) bound to apo(a) which stimulates many proinflammatory pathways in cells of the arterial wall, a key property underlying its pathogenicity and association with cardiovascular disease (CVD). While the liver and kidney are the major tissues implicated in Lp(a) clearance, the pathways for Lp(a) uptake appear to be complex and are still under investigation. Biochemical studies have revealed an exceptional array of receptors that associate with Lp(a) either via its apoB, apo(a), or OxPL components. These receptors fall into five main categories, namely 'classical' lipoprotein receptors, toll-like and scavenger receptors, lectins, and plasminogen receptors. The roles of these receptors have largely been dissected by genetic manipulation in cells or mice, although their relative physiological importance for removal of Lp(a) from the circulation remains unclear. The LPA gene encoding apo(a) has an overwhelming effect on Lp(a) levels which precludes any clear associations between potential Lp(a) receptor genes and Lp(a) levels in population studies. Targeted approaches and the selection of unique Lp(a) phenotypes within populations has nevertheless allowed for some associations to be made. Few of the proposed Lp(a) receptors can specifically be manipulated with current drugs and, as such, it is not currently clear whether any of these receptors could provide relevant targets for therapeutic manipulation of Lp(a) levels. This review summarises the current status of knowledge about receptor-mediated pathways for Lp(a) catabolism.

The use of intracortical microelectrode arrays has gained significant attention in being able to help restore function in paralysis patients and study the brain in various neurological disorders. Electrode implantation in the cortex causes vasculature or blood-brain barrier (BBB) disruption and thus elicits a foreign body response (FBR) that results in chronic inflammation and may lead to poor electrode performance. In this study, a comprehensive insight into the acute molecular mechanisms occurring at the Utah electrode array-tissue interface is provided to understand the oxidative stress, neuroinflammation, and neurovascular unit (astrocytes, pericytes, and endothelial cells) disruption that occurs following microelectrode implantation. Quantitative real time polymerase chain reaction (qRT-PCR) was used to quantify the gene expression at acute time-points of 48-hr, 72-hr, and 7-days for factors mediating oxidative stress, inflammation, and BBB disruption in rats implanted with a non-functional 4 × 4 Utah array in the somatosensory cortex. During vascular disruption, free iron released into the brain parenchyma can exacerbate the FBR, leading to oxidative stress and thus further contributing to BBB degradation. To reduce the free iron released into the brain tissue, the effects of an iron chelator, deferoxamine mesylate (DFX), was also evaluated.

Tremendous efforts have been devoted to the development of future nanomedicines that can be specifically designed to incorporate responsive elements that undergo modification in structural properties upon external triggers. One potential use of such stimuli-responsive materials is to release encapsulated cargo upon excitation by an external trigger. Today, such stimuli-response materials allow for spatial and temporal tunability, which enables the controlled delivery of compounds in a specific and dose-dependent manner. This potentially is of great interest for medicine (e.g. allowing for remotely controlled drug delivery to cells, etc.). Among the different external exogenous and endogenous stimuli used to control the desired release, light and magnetic fields offer interesting possibilities, allowing defined, real time control of intracellular releases. In this review we highlight the use of stimuli-responsive controlled release systems that are able to respond to light and magnetic field triggers for controlling the release of encapsulated cargo inside cells. We discuss established approaches and technologies and describe prominent examples. Special attention is devoted towards polymer capsules and polymer vesicles as containers for encapsulated cargo molecules. The advantages and disadvantages of this methodology in both, in vitro and in vivo models are discussed. An overview of challenges associate with the successful translation of those stimuli-responsive materials towards future applications in the direction of potential clinical use is given.

A methodology to quantify the efficiency of the protein loading and in-vitro delivery for biodegradable capsules with different architectures based on polyelectrolytes (dextran sulfate, poly-L-arginine and polyethylenimine) and SiO

Large floodplains are complex ecosystems at the land–water boundary. Because of rainy and dry seasons, most tropical floodplains are subjected to annual water-level fluctuations. During typical low-water periods, extensive areas of the floodplains are dry. However, relatively small geomorphological differences within the boundaries of the floodplains result in comparatively large differences in the length and depth of inundation and, in turn, the establishment of distinct plant communities, called macrohabitats. The specific ecological conditions of these macrohabitats have to be taken into consideration in the development of sustainable management methods and protection measures. Extreme floods and droughts have very strong effects on flora and fauna. The low hydrological buffer capacity of floodplains makes them vulnerable to anthropogenic changes in hydrology and to the impacts of global climate change. This study presents a macrohabitat classification system that has been applied to three large Brazilian floodplains: the forested Amazonian varzeas and igapos, and the savanna floodplains of the upper Paraguai River (Pantanal of Mato Grosso). Examples are provided to demonstrate the applicability of this system in comparative inter- and intra-wetland studies and therefore its utility in assessing environmental changes, including those arising from global climate change. Our approach can also be used to guide the implementation of sustainable management methods and as a focal point for the development of environmental legislation.